Abstract
Dietary patterns and some dietary components have been linked with dementia. We therefore performed a meta-analysis of available studies to determine whether there is an association between diet and risk of dementia. We included eligible articles and estimated risk ratio (RR) with 95 % confidence intervals (95 % CIs). Finally, there were 43 trials that met the inclusion standard. Some food intake was related with decrease of dementia, such as unsaturated fatty acids (RR: 0.84, 95 % CI: [0.74–0.95], P = 0.006), antioxidants (RR: 0.87, 95 % CI: [0.77–0.98], P = 0.026), vitamin B (RR: 0.72, 95 % CI: [0.54–0.96], P = 0.026), and the Mediterranean diet (MeDi) (RR: 0.69, 95 % CI: [0.57–0.84], P < 0.001). Some material intakes were related with increase of dementia, such as aluminum (RR: 2.24, 95 % CI: [1.49–3.37], P < 0.001), smoking (RR: 1.43, 95 % CI: [1.15–1.77], P = 0.001), and low levels of vitamin D (RR: 1.52, 95 % CI: [1.17–1.98], P = 0.002). The effect of some materials needs further investigation, such as fish (RR: 0.79, 95 % CI: [0.59–1.06], P = 0.113), vegetables and fruits (RR: 0.46, 95 % CI: [0.16–1.32], P = 0.149), and alcohol (RR: 0.74, 95 % CI: [0.55- 1.01], P = 0.056). Thus, the MeDi and higher consumption of unsaturated fatty acids, antioxidants, and B vitamins decrease the risk of dementia while smoking and higher consumption of aluminum increase the risk of dementia. Low levels of vitamin D were associated with cognitive decline. The effect of fish, vegetables, fruits, and alcohol needs further investigation. The findings will be of great significance to guide people to prevent dementia.
This is a preview of subscription content,
to check access.




References
Ogawa S (2014) Nutritional management of older adults with cognitive decline and dementia. Geriatr Gerontol Int 14(Suppl 2):17–22. doi:10.1111/ggi.12252
Solfrizzi V, Capurso C, D'Introno A, Colacicco AM, Santamato A, Ranieri M, Fiore P, Capurso A et al (2008) Lifestyle-related factors in predementia and dementia syndromes. Expert Rev Neurother 8(1):133–158. doi:10.1586/14737175.8.1.133
Sampson EL (2010) Palliative care for people with dementia. Br Med Bull 96:159–174. doi:10.1093/bmb/ldq024
Jiang T, Yu JT, Tian Y, Tan L (2013) Epidemiology and etiology of Alzheimer's disease: from genetic to Non- genetic factors. Curr Alzheimer Res 10(8):852–867
Eskelinen MH, Ngandu T, Tuomilehto J, Soininen H, Kivipelto M (2011) Midlife healthy-diet index and late-life dementia and Alzheimer’s disease. Dement Geriatr Cogn Disord Extra 1(1):103–112. doi:10.1159/000327518
Alles B, Samieri C, Feart C, Jutand MA, Laurin D, Barberger-Gateau P (2012) Dietary patterns: a novel approach to examine the link between nutrition and cognitive function in older individuals. Nutr Res Rev 25(2):207–222. doi:10.1017/S0954422412000133
Sofi F, Abbate R, Gensini GF, Casini A (2010) Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr 92(5):1189–1196. doi:10.3945/ajcn.2010.29673
Crichton GE, Bryan J, Murphy KJ (2013) Dietary antioxidants, cognitive function and dementia—a systematic review. Plant Foods Hum Nutr 68(3):279–292. doi:10.1007/s11130-013-0370-0
Gu Y, Nieves JW, Stern Y, Luchsinger JA, Scarmeas N (2010) Food combination and Alzheimer disease risk: a protective diet. Arch Neurol 67(6):699–706. doi:10.1001/archneurol.2010.84
Etgen T, Sander D, Bickel H, Sander K, Forstl H (2012) Vitamin D deficiency, cognitive impairment and dementia: a systematic review and meta-analysis. Dement Geriatr Cogn Disord 33(5):297–305. doi:10.1159/000339702
Peters R, Poulter R, Warner J, Beckett N, Burch L, Bulpitt C (2008) Smoking, dementia and cognitive decline in the elderly, a systematic review. BMC Geriatr 8:36. doi:10.1186/1471-2318-8-36
Panza F, Capurso C, D’Introno A, Colacicco AM, Frisardi V, Lorusso M, Santamato A, Seripa D et al (2009) Alcohol drinking, cognitive functions in older age, predementia, and dementia syndromes. J Alzheimers Dis 17(1):7–31. doi:10.3233/JAD-2009-1009
Zhu XC, Yu Y, Wang HF, Jiang T, Cao L, Wang C, Wang J, Tan CC et al (2014) Physiotherapy intervention in Alzheimer’s disease: systematic review and meta-analysis. J Alzheimers Dis. doi:10.3233/JAD-141377
Huang TL, Zandi PP, Tucker KL, Fitzpatrick AL, Kuller LH, Fried LP, Burke GL, Carlson MC (2005) Benefits of fatty fish on dementia risk are stronger for those without APOE epsilon4. Neurology 65(9):1409–1414. doi:10.1212/01.wnl.0000183148.34197.2e
Roberts RO, Geda YE, Cerhan JR, Knopman DS, Cha RH, Christianson TJ, Pankratz VS, Ivnik RJ et al (2010) Vegetables, unsaturated fats, moderate alcohol intake, and mild cognitive impairment. Dement Geriatr Cogn Disord 29(5):413–423. doi:10.1159/000305099
Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Aggarwal N, Wilson RS, Scherr PA (2002) Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA 287(24):3230–3237
Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Wilson RS, Aggarwal N, Schneider J (2003) Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol 60(7):940–946. doi:10.1001/archneur.60.7.940
Morris MC, Evans DA, Tangney CC, Bienias JL, Wilson RS, Aggarwal NT, Scherr PA (2005) Relation of the tocopherol forms to incident Alzheimer disease and to cognitive change. Am J Clin Nutr 81(2):508–514
Corrada MM, Kawas CH, Hallfrisch J, Muller D, Brookmeyer R (2005) Reduced risk of Alzheimer’s disease with high folate intake: the Baltimore longitudinal study of aging. Alzheimers Dement 1(1):11–18. doi:10.1016/j.jalz.2005.06.001
Laurin D, Masaki KH, Foley DJ, White LR, Launer LJ (2004) Midlife dietary intake of antioxidants and risk of late-life incident dementia: the Honolulu-Asia aging study. Am J Epidemiol 159(10):959–967
Luchsinger JA, Tang MX, Shea S, Mayeux R (2003) Antioxidant vitamin intake and risk of Alzheimer disease. Arch Neurol 60(2):203–208
Luchsinger JA, Tang MX, Miller J, Green R, Mayeux R (2007) Relation of higher folate intake to lower risk of Alzheimer disease in the elderly. Arch Neurol 64(1):86–92. doi:10.1001/archneur.64.1.86
Zandi PP, Anthony JC, Khachaturian AS, Stone SV, Gustafson D, Tschanz JT, Norton MC, Welsh-Bohmer KA et al (2004) Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the cache county study. Arch Neurol 61(1):82–88. doi:10.1001/archneur.61.1.82
Nelson C, Wengreen HJ, Munger RG, Corcoran CD (2009) Dietary folate, vitamin B-12, vitamin B-6 and incident Alzheimer’s disease: the cache county memory, health and aging study. J Nutr Health Aging 13(10):899–905
Dai Q, Borenstein AR, Wu Y, Jackson JC, Larson EB (2006) Fruit and vegetable juices and Alzheimer’s disease: the Kame project. Am J Med 119(9):751–759. doi:10.1016/j.amjmed.2006.03.045
Scarmeas N, Stern Y, Mayeux R, Manly JJ, Schupf N, Luchsinger JA (2009) Mediterranean diet and mild cognitive impairment. Arch Neurol 66(2):216–225. doi:10.1001/archneurol.2008.536
Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA (2006) Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol 59(6):912–921. doi:10.1002/ana.20854
Merchant C, Tang MX, Albert S, Manly J, Stern Y, Mayeux R (1999) The influence of smoking on the risk of Alzheimer’s disease. Neurology 52(7):1408–1412
Luchsinger JA, Tang MX, Siddiqui M, Shea S, Mayeux R (2004) Alcohol intake and risk of dementia. J Am Geriatr Soc 52(4):540–546. doi:10.1111/j.1532-5415.2004.52159.x
Luchsinger JA, Reitz C, Honig LS, Tang MX, Shea S, Mayeux R (2005) Aggregation of vascular risk factors and risk of incident Alzheimer disease. Neurology 65(4):545–551. doi:10.1212/01.wnl.0000172914.08967.dc
Littlejohns TJ, Henley WE, Lang IA, Annweiler C, Beauchet O, Chaves PH, Fried L, Kestenbaum BR et al (2014) Vitamin D and the risk of dementia and Alzheimer disease. Neurology 83(10):920–928. doi:10.1212/WNL.0000000000000755
Devore EE, Grodstein F, van Rooij FJ, Hofman A, Rosner B, Stampfer MJ, Witteman JC, Breteler MM (2009) Dietary intake of fish and omega-3 fatty acids in relation to long-term dementia risk. Am J Clin Nutr 90(1):170–176. doi:10.3945/ajcn.2008.27037
Devore EE, Grodstein F, van Rooij FJ, Hofman A, Stampfer MJ, Witteman JC, Breteler MM (2010) Dietary antioxidants and long-term risk of dementia. Arch Neurol 67(7):819–825. doi:10.1001/archneurol.2010.144
Engelhart MJ, Geerlings MI, Ruitenberg A, van Swieten JC, Hofman A, Witteman JC, Breteler MM (2002) Dietary intake of antioxidants and risk of Alzheimer disease. JAMA 287(24):3223–3229
Ott A, Slooter AJ, Hofman A, van Harskamp F, Witteman JC, Van Broeckhoven C, van Duijn CM, Breteler MM (1998) Smoking and risk of dementia and Alzheimer’s disease in a population-based cohort study: the Rotterdam study. Lancet 351(9119):1840–1843
Reitz C, den Heijer T, van Duijn C, Hofman A, Breteler MM (2007) Relation between smoking and risk of dementia and Alzheimer disease: the Rotterdam study. Neurology 69(10):998–1005. doi:10.1212/01.wnl.0000271395.29695.9a
Ruitenberg A, van Swieten JC, Witteman JC, Mehta KM, van Duijn CM, Hofman A, Breteler MM (2002) Alcohol consumption and risk of dementia: the Rotterdam study. Lancet 359(9303):281–286. doi:10.1016/S0140-6736(02)07493-7
Launer LJ, Andersen K, Dewey ME, Letenneur L, Ott A, Amaducci LA, Brayne C, Copeland JR et al (1999) Rates and risk factors for dementia and Alzheimer’s disease: results from EURODEM pooled analyses. EURODEM incidence research group and work groups. European studies of dementia. Neurology 52(1):78–84
Barberger-Gateau P, Raffaitin C, Letenneur L, Berr C, Tzourio C, Dartigues JF, Alperovitch A (2007) Dietary patterns and risk of dementia: the three-city cohort study. Neurology 69(20):1921–1930. doi:10.1212/01.wnl.0000278116.37320.52
Commenges D, Scotet V, Renaud S, Jacqmin-Gadda H, Barberger-Gateau P, Dartigues JF (2000) Intake of flavonoids and risk of dementia. Eur J Epidemiol 16(4):357–363
Feart C, Samieri C, Rondeau V, Amieva H, Portet F, Dartigues JF, Scarmeas N, Barberger-Gateau P (2009) Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA 302(6):638–648. doi:10.1001/jama.2009.1146
Rondeau V, Commenges D, Jacqmin-Gadda H, Dartigues JF (2000) Relation between aluminum concentrations in drinking water and Alzheimer’s disease: an 8-year follow-up study. Am J Epidemiol 152(1):59–66
Rondeau V, Jacqmin-Gadda H, Commenges D, Helmer C, Dartigues JF (2009) Aluminum and silica in drinking water and the risk of Alzheimer’s disease or cognitive decline: findings from 15-year follow-up of the PAQUID cohort. Am J Epidemiol 169(4):489–496. doi:10.1093/aje/kwn348
Wang HX, Fratiglioni L, Frisoni GB, Viitanen M, Winblad B (1999) Smoking and the occurrence of Alzheimer’s disease: cross-sectional and longitudinal data in a population-based study. Am J Epidemiol 149(7):640–644
Mehlig K, Skoog I, Guo X, Schutze M, Gustafson D, Waern M, Ostling S, Bjorkelund C et al (2008) Alcoholic beverages and incidence of dementia: 34-year follow-up of the prospective population study of women in Goteborg. Am J Epidemiol 167(6):684–691. doi:10.1093/aje/kwm366
Huang W, Qiu C, Winblad B, Fratiglioni L (2002) Alcohol consumption and incidence of dementia in a community sample aged 75 years and older. J Clin Epidemiol 55(10):959–964
Solfrizzi V, Colacicco AM, D’Introno A, Capurso C, Del Parigi A, Capurso SA, Argentieri G, Capurso A et al (2006) Dietary fatty acids intakes and rate of mild cognitive impairment. The Italian longitudinal study on aging. Exp Gerontol 41(6):619–627. doi:10.1016/j.exger.2006.03.017
Solfrizzi V, D’Introno A, Colacicco AM, Capurso C, Del Parigi A, Baldassarre G, Scapicchio P, Scafato E et al (2007) Alcohol consumption, mild cognitive impairment, and progression to dementia. Neurology 68(21):1790–1799. doi:10.1212/01.wnl.0000262035.87304.89
Llewellyn DJ, Lang IA, Langa KM, Muniz-Terrera G, Phillips CL, Cherubini A, Ferrucci L, Melzer D (2010) Vitamin D and risk of cognitive decline in elderly persons. Arch Intern Med 170(13):1135–1141. doi:10.1001/archinternmed.2010.173
Peters S, Reid A, Fritschi L, de Klerk N, Musk AW (2013) Long-term effects of aluminium dust inhalation. Occup Environ Med 70(12):864–868. doi:10.1136/oemed-2013-101487
Simons LA, Simons J, McCallum J, Friedlander Y (2006) Lifestyle factors and risk of dementia: Dubbo study of the elderly. Med J Aust 184(2):68–70
Cervilla JA, Prince M, Mann A (2000) Smoking, drinking, and incident cognitive impairment: a cohort community based study included in the gospel Oak project. J Neurol Neurosurg Psychiatry 68(5):622–626
Doll R, Peto R, Boreham J, Sutherland I (2000) Smoking and dementia in male British doctors: prospective study. BMJ 320(7242):1097–1102
Kroger E, Verreault R, Carmichael PH, Lindsay J, Julien P, Dewailly E, Ayotte P, Laurin D (2009) Omega-3 fatty acids and risk of dementia: the Canadian study of health and aging. Am J Clin Nutr 90(1):184–192. doi:10.3945/ajcn.2008.26987
Afzal S, Bojesen SE, Nordestgaard BG (2014) Reduced 25-hydroxyvitamin D and risk of Alzheimer’s disease and vascular dementia. Alzheimers Dement 10(3):296–302. doi:10.1016/j.jalz.2013.05.1765
Otaegui-Arrazola A, Amiano P, Elbusto A, Urdaneta E, Martinez-Lage P (2014) Diet, cognition, and Alzheimer’s disease: food for thought. Eur J Nutr 53(1):1–23. doi:10.1007/s00394-013-0561-3
Kalmijn S, Feskens EJ, Launer LJ, Kromhout D (1997) Polyunsaturated fatty acids, antioxidants, and cognitive function in very old men. Am J Epidemiol 145(1):33–41
Morris MC, Evans DA, Schneider JA, Tangney CC, Bienias JL, Aggarwal NT (2006) Dietary folate and vitamins B-12 and B-6 not associated with incident Alzheimer’s disease. J Alzheimers Dis 9(4):435–443
Wang HX, Wahlin A, Basun H, Fastbom J, Winblad B, Fratiglioni L (2001) Vitamin B(12) and folate in relation to the development of Alzheimer’s disease. Neurology 56(9):1188–1194
Grant WB (2009) Does vitamin D reduce the risk of dementia? J Alzheimers Dis 17(1):151–159. doi:10.3233/JAD-2009-1024
Annweiler C, Rolland Y, Schott AM, Blain H, Vellas B, Herrmann FR, Beauchet O (2012) Higher vitamin D dietary intake is associated with lower risk of Alzheimer’s disease: a 7-year follow-up. J Gerontol Ser A Biol Med Sci 67(11):1205–1211. doi:10.1093/gerona/gls107
Singh B, Parsaik AK, Mielke MM, Erwin PJ, Knopman DS, Petersen RC, Roberts RO (2014) Association of Mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis 39(2):271–282. doi:10.3233/JAD-130830
Carmelli D, Swan GE, Reed T, Schellenberg GD, Christian JC (1999) The effect of apolipoprotein E epsilon4 in the relationships of smoking and drinking to cognitive function. Neuroepidemiology 18(3):125–133, 26204
Dufouil C, Tzourio C, Brayne C, Berr C, Amouyel P, Alperovitch A (2000) Influence of apolipoprotein E genotype on the risk of cognitive deterioration in moderate drinkers and smokers. Epidemiology 11(3):280–284
Loef M, Walach H (2012) Fruit, vegetables and prevention of cognitive decline or dementia: a systematic review of cohort studies. J Nutr Health Aging 16(7):626–630
Peters R, Peters J, Warner J, Beckett N, Bulpitt C (2008) Alcohol, dementia and cognitive decline in the elderly: a systematic review. Age Ageing 37(5):505–512. doi:10.1093/ageing/afn095
Luchsinger JA, Tang MX, Shea S, Mayeux R (2002) Caloric intake and the risk of Alzheimer disease. Arch Neurol 59(8):1258–1263
Geda YE, Ragossnig M, Roberts LA, Roberts RO, Pankratz VS, Christianson TJ, Mielke MM, Levine JA et al (2013) Caloric intake, aging, and mild cognitive impairment: a population-based study. J Alzheimers Dis 34(2):501–507. doi:10.3233/JAD-121270
Acknowledgments
This work was supported by grants from the National Natural Science Foundation of China (81471309, 81371406, 81171209), the Shandong Provincial Outstanding Medical Academic Professional Program, Qingdao Key Health Discipline Development Fund, and Qingdao Outstanding Health Professional Development Fund.
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of Interests
The authors declare no conflicts of interest.
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
ESM 1
(PDF 624 kb)
Rights and permissions
About this article
Cite this article
Cao, L., Tan, L., Wang, HF. et al. Dietary Patterns and Risk of Dementia: a Systematic Review and Meta-Analysis of Cohort Studies. Mol Neurobiol 53, 6144–6154 (2016). https://doi.org/10.1007/s12035-015-9516-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12035-015-9516-4